Wednesday, April 18, 2012

Birth Story: Part 1 - The Itch

This is the beginning of our birth story. It is filled with the unexpected, yet there is never any doubt that God was faithful and in control. Click here to read Birth Story: Preparations if you haven't already.

On Wednesday, December 21st, I was 36 weeks pregnant and busily getting ready for Christmas, our wedding anniversary, and a baby - all happening one right after the other. I was feeling wonderful and truly loved being pregnant. My pregnant self was the new normal and my husband was just as thankful as I was for no morning sickness or weird cravings, just the usual ache in my ribs and back from my growing little one. It had been a relatively easy 9 months (a blessing!) and here we were nearing the end. All was well until I jumped in the shower that evening and noticed I had the itch...

A few days prior I noticed my shins were itchy and sometimes my arms felt itchy too. I just assumed it was common with being pregnant until that Wednesday evening when my palms, thighs, and feet also became itchy. There was no rash or anything - just an itchiness that would not cease. I put on some Eucerin and got into bed with my laptop so I could look up the reason behind my urge to scratch. I found that throughout pregnancy whenever something seemed different with my body, I would search for the reason why and this made it easier to accept any discomfort with less complaining. It is fascinating what goes on inside of you during those 9 months - your body works so hard! As I googled my symptom, I found myself pouring over forums and websites of women sharing their opinions and stories behind the itch of their pregnancies. It was well past midnight when I shut off my computer and had come to a conclusion: I was to call my midwife in the morning.

There were so many different opinions about itchiness while I was reading, that overall it seemed like a harmless, yet annoying, common pregnancy symptom. What prompted me to call my midwife were the few responses from women that urged others to call their doctor and have their bile acid levels checked for what is known as Intrahepatic Cholestasis of Pregnancy, or just Cholestasis of Pregnancy. These women thought they just had a normal pregnancy itch too, until they were diagnosed with cholestasis - a condition that must result in early delivery of the baby. Cholestasis is harmless to the mother, aside from intense itching, but can be harmful to the baby. They do not know why it happens, and it is quite rare, but from what research has been done it shows that the mother's pregnancy hormones interfere with the liver and gallbladder's ability to store bile acid. This excess bile is entered into the bloodstream. Bile in the bloodstream is what causes concern for the unborn baby. Thirty-seven weeks is the recommended time of delivery and not much is known about what happens to the baby if the mom is left to go full term (some statistics state a low percentage of stillbirths if no induction takes place). To be on the safe side, I knew making an appointment with my midwife the very next day was the smartest thing to do, rather than wait until my checkup appointment on Tuesday.

On Thursday I went in for an appointment and shared my concerns. Thankfully, the midwife I met with that day was fully aware of the condition (due to its rarity, many ob-gyns are not) and she ordered a blood test to be done while I was there, as well as a non-stress test. There is a liver function test (LFT) and a bile acids test. From what I read the night before, some doctors just do a LFT and unfortunately these results can be misleading. If just a LFT is performed, you should request for a bile acids test to be done too. This takes longer for the results to come in because it has to be sent to a special lab, but it is much more conclusive. I wasn't overly concerned when I left the office that day because I felt like I didn't have near the intense itching that women with cholestasis described online. Some would scratch until they bled and that was not me. I was bothered by it in the mornings and at night, but hardly at all throughout the day. I called Matt to let him know the results would be back right after Christmas and we prayed for peace and health of our son.

Christmas arrived that weekend and all was great as we celebrated one of the best holidays of the year. The impending results of my blood test were only a thought, and not a worry, as we stayed busy soaking up family time and our last Christmas without any children. Matt and I knew that our next Christmas would be so different with a little one and we enjoyed dreaming what that would be like. Tuesday soon arrived and Matt headed back to work as I headed back to the doctor's office for my regular checkup. Only my LFT results were in and they showed that my liver was just fine - a praise. My symptoms had not worsened and I didn't spend much time worrying about waiting on the results of my bile acid test. I felt good and the many kicks and tumbles of Matthew II in my belly let me know he was doing good too. I spent the night of the 27th on an anniversary date with my husband of three years. 3 years and almost a family of 3... I was feeling so blessed.

On Wednesday the 28th, one week from when I noticed I was itching more than usual, I went about running errands around town. I pulled into a local gas station to run in and get a gatorade because I was so over drinking water! As I walked back to my car, my phone rang and it was the doctor's office. The nurse asked if my blood test results were discussed with me at my appointment the day before and I told her how only my LFT results were in and all was good. She said that my bile acid levels came back and they were elevated (my heart literally felt like it stopped for a second). The nurse said she was going to have a midwife call me as soon as one was available and I immediately called my husband. I swallowed my worry and asked him to pray because I knew full well that elevated levels meant an induction was in the future. I secretly hoped my levels weren't high enough or that it was all a misunderstanding. We prayed over the phone together before I called my mom and asked her to pray too. I let them both know I would call as soon as I heard from the midwife.

About an hour later I was wandering the aisles of the grocery store, checking items off of my list. I was almost done when my phone rang while I was walking down the cereal aisle. I took a deep breath to calm my nerves and answered the phone, while thinking in the back of my head that God is in control of my situation. The midwife, Kathy, informed me that I do indeed have cholestasis of pregnancy. She explained this in detail to me and said my levels were at a 31 when they should be below 10. I felt frozen and forced myself to remain as normal as possible so I continued to push my buggy over to the cheese, but everything was slowly becoming a blur. I asked her what my options were and she said that as medical professionals, they have to call for an induction. Kathy shared that not much is known about cholestasis, but they do know that if I wait to labor naturally, there is no guarantee that my baby would be healthy and safe. I understood this and when asked if I would come in to be induced, I of course agreed. I told her I'd like to speak with my husband about it all right away and that's when she ended the phone call with a statement that sent my head spinning... "I will have you scheduled to come into the hospital tonight at 8:30 for an induction."

Tonight... Tonight?! I was not prepared to hear this. I knew I was to be induced, but that night? In just 6 hours? I honestly thought that if I were to be induced, it would be in a couple days - not in a few hours. I hung up the phone, assuring her I would call back to confirm, and willed my body with all my might not to cry or break down right there in front of the cream cheese. I suddenly felt sick and my body felt so heavy as I tried to put on my brave face and finish my shopping. I knew that I couldn't possibly call Matt and tell him what I just heard while still walking around Lowe's Foods... I had to wait until I was in the car. I remember walking down the frozen foods aisle to grab the last items on my list and I could hardly see through the tears that rushed to my eyes. I clenched my jaw to keep the tears from streaming down and forced a smile to my cashier. The thoughts in my head were going a mile a minute - was my baby really okay? Induction is not natural labor! This is not part of my birth plan... I said I'd be flexible, but induction never crossed my mind! Oh no, pitocin makes contractions worse causing more discomfort than natural contractions. And what about Matt? What's he going to say? I need him. What did I do wrong? I can do this. I have to be strong. My baby is coming. I don't understand. God, help me understand. God, help me. Why? Why? WHY?

As I loaded the last of the groceries in the suburban the tears came. I couldn't stop them and I quickly pushed the buggy back to its return before people stared at me. I kept my eyes down and fumbled for the keys that I could barely see. I needed to call my husband and hear his reassuring voice. I drove a few rows over to an empty spot of the parking lot and waited for him to answer. I tried so hard to keep my voice steady, but it was no use. I broke down on the phone and told him he had to come home and that we had to go to the hospital tonight. I remember the surprise in his voice when I said that word... tonight. He thought I was silly for apologizing about making him leave work unplanned, but at that point I was starting to feel responsible for everything. Those mile-a-minute thoughts were quickly running out of control as I couldn't seem to think straight anymore. Matt lovingly reassured me that everything was going to be okay, and with joy in his voice he said that we were going to meet our son soon. I couldn't help but smile when he put it like that... yes, induction guaranteed that we were going to meet our son sooner than expected.

On the way home I called my mom and told her what I knew. As I pulled in the carport, I sat there and listened to her reassure me, like Matt had, that this was all part of God's plan. She asked if I needed her to do anything or bring anything over and I replied with a no thank you. I wanted to go on as normally as possible and would call her after she got out of church to let her know what room we were in, etc. Matt pulled in just minutes after I finished unloading the groceries and he wrapped me in a strong embrace as I just crumbled into his arms. I couldn't say anything. Him holding me brought back the flood of tears again and he led me over to the couch to pray. I explained to him that I'm just so upset, but I can't really pinpoint what it is exactly that is upsetting me. I wasn't upset about laboring because we had prepared and planned for that and I wasn't upset about the health of our baby because I had a peace that can only come from the Lord that our little boy was going to be just fine. I know that part of my reason for being upset was that being induced meant I wouldn't get to start labor naturally... something I really desired. Most of all, my flood of emotions came from the shock that it was all happening so quick and I had no control. Yes, that was the reason.

We decided to eat the dinner I had originally planned for that evening and then go for a nice walk down our quiet, country street before heading to the hospital to check-in. All was to carry on as normal as possible. Matt made some phone calls to his family to update them while I stepped outside and called my dear friend, April. I sat in the adirondack chair looking out at our yard and briefly shared with her what was taking place. April said something that touched me so deeply and provided instant comfort. She said, "Olyvia, the Lord has always known Matthew's birthday," and that simple truth reassured me yet again that God was in control. I told Matt that statement from April and we both smiled at the thought of meeting our son so soon! We ate dinner, did some last minute laundry, and even managed to take some belly photos like we'd been planning to do. Oh, and let's not forget that we did go to Wal-Mart too so I could buy two cheap gowns to labor in (I wanted something other than the hospital gown). My favorite part of the evening though was when we took a quiet walk down our street, hand in hand. Although I was nervous, I felt comforted walking with my husband, ready to embrace what scenarios were ahead.

Wow, reading about how you found out about everything is a lot different hearing from your point of view in such detail! It gave me chill bumps! I can't believe you could finish grocery shopping...you are awesome! ;)

A different blog friend of mine had the same condition! I can't wait to read the next part of this birth story.

As I side, I had to be induced too, but mine was because I had preeclampsia - I was actually relieved though, because I was afraid to wait too long since preeclampsia can result in placental abruption - I wanted to be induced at that point! :-)